Insurance is NOT the Prescription for American Poor Health

This article was originally published in May 2009 –

The Almost Daily Binx, San Jose-CA, V.A.Caminiti – [Second in a series]

Public Safety / Public Health

…capitalism mutated in the very same way as we encouraged the banking industry to strip safeguards

Can you imagine if you had to be insured to receive basic police services?  How about clean water?  Sewer?  What if you dialed 911 and the operator asked you for your location and your 911 insurance code?  How did the American public become so disinterested and callous in only a few short very greedy years.  Once again, our flaws have seemed to overwhelm our instincts.  Even self-preservation and our natural desire to propogate the species seems to have been compromised to our own detriment.  Isn’t it unnatural for us to not be concerned with the health of all our neighbors – their well being.  How did we become cheerleaders against ourselves – humanity ?

Be very careful and very thorough when approaching this discussion.  The rules, the basis and the players have all changed.  When this discussion took place back in the 1960’s – the very same insurance companies that were prohibited from engaging in risky investments with their financial reserves were essentially providing a public service.  But alas, this is where American capitalism mutated in the very same way as we encouraged the banking industry to strip safeguards and effective regulation, such as Glass-Steagall.

Capitalism is a particularly useful economic tool.  It inspires great things and great philanthropy.  Unfortunately, there is a selflessness to philanthropy and charitable deeds that seems to have eluded many Americans.  While it is a great transition to move from selfishness to selflessness – the journey of the transition is a school unto itself.  Humility knowledge and the gift of discernment may in fact be the destination; however this is all as personal as prayer.  Our public practices are the product of this personal investment; and our business practices can be joyful in the fact that as capitalists and business owners we are part of a community of those that make our business run efficiently and profitably.   Whether a business owner, operator or employee … we all have the responsibility to contribute to the public welfare as well as for those around our own campfire.

This article doesn’t have sufficient literary real-estate to foot-note all the particulars so without apology we’ll aim for bold points.

Cui BonoWho benefits?

Shareholders, stakeholders and investors benefit.  And any departure from this financial turbine is described by the neo-con extreme rightists as a move toward Socialism.

This Latin phrase familiar to many means – ‘who benefits?’  Precisely.  Who benefits if our Health approach is saddled with not one, not two but three layers of profit for absolutely no value to the insured?  Who?  Well it is shamefully simple – the industries that have self-proclaimed they are essential to the delivery of health care – but actually – they deliver the illusion of health care and enormous amounts of red-tape and acrimony.  Millionaire doctors are common-place.  We’re not talking about upper middle class, respectable gentry – we’re talking millionaires in alarming disproportion to the ability of their customers to deliver that kind of wealth for services.

The answer to this puzzle is even more alarming.  Just imagine that a group of entrepreneurs managed to create a collective of physicians and hospitals and convince them that they could guarantee payment for performed services.  We’ll call them the health insurance group analysts.  Now imagine that small private and institution run hospitals are bought up by another entrepreneurial enterprise offering consolidation of services in order to increase profit and contain costs.  Sounds great, right? And then let’s round it off with yet another group that helps design and counsel physicians and hospitals in how to play the game.  The only thing we haven’t actually talked about yet is delivering health care to sick people – so far the discussion is only about money.  And there’s more to come.  Public offerings, new consolidators of health administration and create the fertile birth canal for an entirely new industry; that is, Medical Administrative Services companies whose primary deliverable is processing the voluminous medical insurance paperwork for corporate physicians.

Who benefits?  Shareholders, stakeholders and investors benefit.  And any departure from this financial turbine is described by the neo-con extreme rightists as a move toward Socialism. After all, the promotion of the public well-being has been removed from the very essence of corporate capitalism in stark contrast to its very reason for existing – so why not replace the beneficiaries of health system with shareholders instead of citizens.  The neo-cons and the convoluted agenda they promote have altered the course of modern society, backward to the 1920’s.  It appears the only public services left that haven’t been dismantled are Police, Fire, Water and Sewer – but not for the lack of trying.  In many enclaved real-estate developments around the country, insurance company underwritten private fire companies have been put into service.  They respond to fires of their insured – only.  Sound like the roaring 20’s?  Does it ring of ‘protection’ schemes during the height of the Volstead Act and other ancestors of the equally disturbing Patriot Act?

Debating / The Baiting

…and other buzz words that are the intellectual equivalent of knock-out drops are still the descriptive terms for the argument.  That is to say – the arguments they are having in the public forum have been crafted by the insurance industry.

The Argument for Basic Public Health – what the disrupters call Socialized Medicine – has never been stronger or more sensible.  Tragically though, half the support for the argument disappears because Progressives and Liberals have not been represented – graft free – through the Democratic Party.  The public may be “trusting” their Democratic President with unprecedented solidarity – but they are not as trusting of the Democratic Congress.  Much of this is the result of desperate Rightist pundits working the rope lines whenever and wherever possible.  Hillary Clinton was famously lampooned by ultra-rightists talking heads for her clumsy declaration of a ‘Vast Right Wing Conspiracy’ – but as history has revealed, there are plenty of Right Wing C0-dependents deserving of scrutiny and deposition, at the very least.

However, a significant amount of skepticism haunts Democrats and will continue to haunt them because of the public perception that they were nothing more than ‘eloquent shoulder-shruggers’  that argued vociferously during elections but actually accomplished little else during the 12 years, including 6 years of total American National Government madness.  The bulk of the screaming and dissent ultimately emanated from the Internet wired public. Very few voices in the Democratic Party were brave enough to live their convictions and distinguish themselves with articulate disagreement or simply brave fundamental disagreement.  Sen. Russ Feingold, D-Wis and Rep. Dennis Kucinich, D-Ohio, respectively, come to mind as demonstrative of some of the distinguished few.  And while there are more – most played it safely by putting on their war-paint for Kodak moments, while the public groundswell shook them up.  If nothing else, the Democratic Party went through some significant changes it hadn’t planned when many of the dinosaurs were retired during the last Democratic portion of the last Presidential contest.  So keep in mind – supporters of the President are admiring him for being a Republican and a Democratic dinosaur slayer, although Congress does not share that distinction.

Surely the endless stream of Congressional tidbits about entitlements, insurance reform and other buzz words that are the intellectual equivalent of knock-out drops are still the descriptive terms for the argument.  That is to say – the arguments they are having in the public forum have been crafted by the insurance industry.  They haven’t been crafted around American Health, yet we bought the bait and are fishing with it.   The simple fact is – the reason our health care is so expensive in this country is fundamental.  Unlike public safety, Police, Fire, Water, Sewer and other basic citizen’s services – health is for profit and the ultimate goal of the insurance companies is to minimize benefits and maximize profits. That might even work in a well running capitalistic economy, but that train is most demonstrably off-the-rails as well.

We have been, in effect, brain-washed into believing that our health system is requires insurance reform, when simply – no insurance would be the better solution.  A public health system serves everyone and if those of significant wealth chose to have private health services – the system would in no way prevent it.  Similarly, insurance fraud – one of the singularly most expensive non-return expenses of our health system, would essentially vanish.  The opportunity for young people to participate in community service by volunteering as part of National health programs could help end the reign of terror held over us by the collective avarice driven by the requirements of  ‘return-on-investment’ of  insurers and health services companies.

What’s the Prescription?

… recapture our self-respect and once again become brave good neighbors and partner with our brave young citizens who have put their healthy young blood on the line without question, while we have sat idle and permitted the looting of our treasury and over 55 years of international good-will and leadership.

It seems as though we need to finish the diagnosis in order to prescribe a fix.  But this becomes particularly difficult because Congress has made some startling assumptions.  That is to say, that by empowering only the parties that abused the system and engineered a health insurance paradigm that ostensibly circumnavigates accessible efficient health care – we’re in actuality only treating symptoms and not the underlying disease.  At the very least, this is an overwhelming deficit in our overall public safety and Homeland Security approach, which should be of paramount concern when talking about the overall health of Americans.

The health care reform discussion continually addresses improving the obfuscation as though there were legitimate solutions to be found, therein.  There haven’t been and will not be solutions by supporting an approach that at its roots is health-for-profit.  That would be as inane as suggesting that an alcoholic should be treated by changing brands of Gin.

We need to call-0ut the writers of the new public lexicon that have indoctrinated an alarming number of Americans in believing that a responsible functioning public health system is tantamount to Communism.  We need to demand that public figures be held accountable for their rhetoric and challenge those that have used their seat or office in Congress as a personal lobbying firm shilling for corporate interest instead of representing the public good as they promised by taking their Oath of Office.  So we must begin with ourselves.  Our understanding of health – preventative medicine – education – exercise – nutrition needs and enormous overhaul. But, equally important – we need to consider how insurance became the controlling factor in delivering health services.  After close historical and modern perusal, it is clear that these additional burdens to the pockets of Americans were designed out of greed, not an interest in protection as is suggested by aid or relief, but perhaps more in line with “protection” as in type of policies the Sopranos’ might offer their clients.

Here’s a prescription for another common unfortunate ailment – complacency:

  1. We recapture our initiative to think in private and practice in public.
  2. We stop promoting bad practices and stop habitually adopting talking points of broadcast ideologues that profit by misinforming the public and further profit by shilling for financial interests.
  3. We exercise our capitalistic right to withhold business from broadcast personalities that pretend to be journalists and actually engage not in commentary but in propaganda, even if inconvenient.
  4. We (many of us) must admit that we were willing accomplices and contributed to this mess by our actions or inactions.
  5. We take responsibility not only for the welfare of our families or those we hope to impress – we take responsibility to think on a larger scale than our personal comfort and thus improve our Nation.
  6. We take the time to know things that are important and stop making excuses because it takes time or interferes with our leisure.
  7. We recapture our self-respect and once again become brave good neighbors and partner with our brave young citizens who have put their healthy young blood on the line without question, while we have sat idle and permitted the looting of our treasury and over 55 years of international good-will and leadership.
  8. We do not live in fear and we practice rules of law – instead of languishing in rules of exception.
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Health Care – Part 1 : The Financial Hypnosis

Briefly

“.. Health Insurance, uses actuarial studies but doesn’t actually deliver Insurance.”

This article is going to be a look at the transformation of what was an obvious and proven approach to health care and how, lobbyists, financial companies and politicians forced the public discussion in a different direction and convinced many Americans to cheer for a system that steals from them.   While this article is an overview – its focus is on how the discussion changed and why.

There are a few quick terms that need to be clarified:

1. Patient: A patient is someone that is suffering illness and requires, medical counsel, education or medical treatment.  For the purposes of this discussion, there is no illness associated with breast augmentation, lypo-suction, or any of the the other cosmetic procedures delivered through health care professionals.

2. Finance Co.: This is a company that refers to itself as Health Insurance, uses actuarial studies but doesn’t acutally deliver Insurance.  What the Finance Co. provides is the equivalent of a pre-paid telephone card – however, they have the right to increase the connection charge – on the fly, with little recourse to the patient.

3.  Medical Professionals:  Doctors, Nurses, Scientists, Medical Admin, Services and Support; including public health services (gov’t)

4.  Non-medical Professionals: Massage therapists, teachers, instructors, social service representatives, other public health services (gov’t)

5.  Non-Insurance Medical Providers: Kaiser-Permanente is the perfect example. We will refer to it in subsequent installments of this article.

How DId the Discussion Change from Health Care to Health Insurance?

“… drama in the waiting room, eerie reminders of pre-Civil Rights days in the deep South.”

Fifteen years ago, there was a National discussion about health care, and 20 years before that, there were similar discussions.  The hiatus was supplied by the Vietnam war, Richard Nixon’s struggle with the rules, the warm-up energy crisis and Oliver North’s homegrown foreign diplomacy. Scores of other distractions were spawned by America’s financial boom, a nice way to describe the national addiction to investing and exponential profits that we’ll further refer to as financial crack cocaine.

When the discussions re-started, they included everything from expanding the public health service to providing basic health care for Americans.  Not only basic health care but health education and preventive medicine.  As it is, there is no incentive for delivering preventative medicine in the insurance company dominated health system – yet there are numerous financial incentives for treating more and more illness.  In short, the system, as is, becomes more profitable for investors if the number of sick people rises.  The system by design is flawed.  Consider a private police department whose investors privately hope for higher crime or less public safety in order to increase profits.

Now consider that the cost of detectives is driven by market conditions, and the amount of attention they can dedicate to particular cases is based on the overall profit of those cases, determined by the Financial Co-op.  Public safety, no longer driving the results, the highest profit is realized when more and more cases are opened and crime is elevated, since the crime victim must pay, or pay through a Finance Co., for services.

So as you can see, for the purposes of Part One – we propose that Health Care is essentially the same as Public Safety, Public Water and Sewer, Public Works.  There is only one answer to how the discussion was altered and thereby further dividing classes of American citizens.  The most obvious being Insured and Uninsured.  While many may not see this as a ‘Class’ distinction – visit  Medical Professional company in your area and observe the drama in the waiting room, eerie reminders of pre-Civil Rights days in the deep South.

Pay Attention to Small Stuff

“… the payment was spread among the entire school population.”

For the purposes of this section of the article – we’re going to have to stick to practices and not specific people or companies.  While we have some excellent examples of specific people and companies that benefited greatly by redirecting the national discussion, we’ll save that for later chapters, with footnotes and research material.

Clearly, the changes were motivated by a new approach to economics.  After being indoctrinated with ‘free-market’ platitudes, even High School football teams were looking for revenue far beyond what booster clubs and community fund-drives could yield.  So the answer is appetite.  The American appetite for opportunity and great return.

When Junior High schools were selling real-estate to Coke and Pepsi so that they could line the halls with machines selling high fructose corn syrup laden carbonated drinks to children; we were trading public health for corporate finance.  While it paid for the illuminated scoreboard on the football field and much more updated uniforms and equipment, the payment was spread among the entire school population.

While on the surface it seems to be logical, there was a serious breech of both public health and the loco parentis care of our children of which public schools are charged.  But ‘the Beat goes on’ seemed more enticing than pedantic pleas of health professionals about force-feeding our youth sugary water.  And anyone that doesn’t believe that Soda dispensing machines strategically located throughout a public school isn’t force-feeding than we beckon a more suitable word.

Courting Independence

“… then you were going to get credit – big and fast.”

The financial appetite for return on investment permeated the atmosphere.  IRA’s abounded benefiting investors with deferred income tax and lower base taxes by lowering their taxable income.  It was all the talk at the supermarket, at the beauty parlor, at the VFW and at the golf course.  An entire generation of tax planners were armed with Texas Instruments printing calculators in order to show investors, just how many millions they would have at early ’80s interest rates of 12%.

These opportunities were not curtailed simply by the sudden drop in interest rates as the stock market began its first surge – because the SEC swung open the doors at the behest of the Reagan Administration to permit individuals to personally direct their retirement money into the risky equity markets.  Penny stocks abounded with the lucre of  Mom’s and Pop’s, although, much of it evaporated by the late 80’s as the equity markets – adjusted.  That’s what they call crashes because of uncontrolled financial growth – “adjustments”.  On the way up … they don’t call them anything, because no one can hear over the cheering.

Pick a Card – Any Card

“.. create a highly lucrative financial turbine of the insurance company.”

During this period of time, gasoline rose in price, food rose in price and health care rose in price.  A society stuck for a  ready cash with appetites further whetted by buying stocks and bonds on margin; they started abandoning the sound financial tenets of their roots and willingly accepted credit cards in the simple recruitment terms of the credit card companies.  Buying on credit was easy. It was certainly an analgesic to financial pain -moreover – the new American voracious appetite for  acquiring  more “stuff” wouldn’t be derailed because the disposable cash dried up.  Not for a second.  If you could prove that you were stupid enough to load up your retirement portfolio with Penny Stock get rich quick schemes and would be ‘market averaging’ for the next 100 years in order to get your principle back – then you were going to get credit – big and fast.

The Finance companies were watching and in the game.  They were buying up medical services companies and even hospitals through holding companies and even real estate trusts.  After all, if you are going to expand a business that collects money , shouldn’t you also own the companies that you ultimately pay.  In this way you can add the power of the check book while containing costs. Further,  by leveraging the assets of the holding company by selling it off to investors – the Finance Co. in actuality, creates a highly lucrative financial turbine from what appears to be an insurance company.  Ultimately, taking more in than it pays out,  the Finance company maintains high profitability by delivering less health care to the insureds.  In effect, they create a layer that in conclusion, does nothing but convert the massive buying power of an organized group, and convert it into investor profit instead of an actual comprehensive medical plan.  It’s very much like the new Electronic Scoreboard and the Soda machines.

To be continued ……  part Two next week.